Effectiveness of a pharmaceutical consultation in the care of cancer patients receiving oral anti-cancer therapy: PHACON study.
Authors: Saad Mohamed, Alice Viallet, Virginie Lamand, Audrey Le Roy, Hugo Picchi, Julie Lavole, Claire Mallaret, Roxana Pristavu, Hélène Vanquaethem, Carole Helissey
Journal: Journal of Clinical Oncology (2023)

e13670 Background: The emergence of oral cancer therapies (OCT) has improved the management of cancer patients. However, the specific toxicities of these OCT and their outpatient management raise many challenges, such as compliance and drug interactions. Pharmaceutical consultation (PC) takes into account all the medications taken and to be taken by the patient when a new prescription is issued. It involves the patient and is based on information sharing and multi-professional coordination. It prevents medication errors by facilitating the transmission of complete information between healthcare professionals. Despite these benefits, this PC is barely implemented in patient care. Methods: This prospective study was conducted at the Military Hospital Bégin. All patients with an OCT were eligible for PC. The PCcircuit was as follows. 1) PC was prescribed by the referring oncologist via the prescription software. 2) The patient was contacted by the hospital pharmacy to schedule an appointment. 3) On the day of the PC, the patient was greeted by the pharmacist in the hospital's outpatient department. The objectives of the PC were presented. The pharmacist reviewed with the patient all the treatments taken and also the herbal medicine. He presented the OCT, its objective and the recommended times of intake in a personalized manner. 4) Patient's local pharmacy was contacted by phone to ensure a close follow-up. A patient-centered multidisciplinary update is performed regularly. The objective of our study was to evaluate the feasibility of this PC and its acceptance by patients and health-caregivers. Results: 53 patients were enrolled between October 1 st 2021 and January 31 st 2023. The median age was 70 years (range 27-89). 80% presented a metastatic stage, and the most represented cancer was prostate (27%), breast (25%), lung (13%), and kidney (11%). The OCT were mainly TKI (62%) and hormonotherapy (30%). 47% of PC led to pharmaceutical interventions, notably to adapt the dosage and/or the choice of the molecule, in order to limit interactions and side effects. 41 city pharmacies were contacted (77%). Only 5 pharmacists were aware of these treatments (12%). 98% appreciated to be informed about the OCT received by their patient. All the patients were satisfied with this treatment and in particular with the information they received about herbal medicine. All practitioners reported a marked improvement in the management of their patients since the implementation of PC. Conclusions: Our study demonstrated the feasibility of the implementation of PC. This consultation allowed an adaptation and a therapeutic follow-up. All patients were satisfied and had a better adherence to their care. This secured the patient's care in order to maintain the therapeutic benefit and limit the side effects. Our study also shows the importance of the link between the city and the hospital in patient care via pharmacists.